Objective To summarize the perioperative experience of nursing the middle-aged and elderly patients of lumbar spinal stenosis and degenerative lumbar scoliosis treated with posterior or transforaminal lumbar interbody fusion. Methods Posterior or transforaminal lumbar interbody fusion was performed in 69 middle-aged and elderly patients with lumbar spinal stenosis and degenerative lumbar scoliosis. Nursing measures included evaluation and treatment of complications, preoperative guidance for surgical body position, and postoperative close monitoring, treatment of complications and functional exercises. Results The operation on all the 69 patients was smooth, with surgical time ranged from 3 to 7 hours and bleeding volume between 300~750 mL. Postoperatively, 9 patients suffered from CSF leaks, 3 ones had a screw loose by imageology, 2 did from pneumonia, 2 did from DVT, and 3 did from depression. After clinical management and nursing, all the patients were cured and discharged. Conclusions Meticulous clinical treatment and nursing of preoperative complications and instructions on body position are the foundation for successful surgeries. Postoperatively, close monitoring, management of the complications and the instruction on functional exercises are guarantees for the successful surgeries.

The essay discussed the necessity and essentiality of medical moral education to intern,in the background of market-oriented economy.To summarize ways of medical moral education to intern.

Objective: To establish an HPLC fingerprint spectrum of Mongolian medicine Rubus sachalinensis. Methods: An HPLC was performed on the column of phenomsil ODS (250 mm × 4. 6 mm,5 μm) with the mobile phase of 0. 3% phosphoric acid-MeOH with gradient elution at a flow rate of 1. 0 ml·min-1 ,the detection wavelength was 290 nm, the column temperature was 25 ℃and the injection volume was 20 μl. Totally 7 batches of Rubus sachalinensis from different habitats were analyzed. Results:The RSD of relative retention time of the common peaks of Rubus sachalinensis was less than 3%, and that of relative peak areas was below 3%as well, which were in accordance with the requirements of fingerprint. Conclusion:The established HPLC fingerprint has promising accuracy, repeatability and stability, which can be used as one basis for the quality control of Rubus sachalinensis.

Hemophagocytic lymphohistiocytosis(HLH), also known as hemophagocytic syndrome(HPS), is a hyperinflammatory syndrome caused by multiple etiologies.Interferon-γ(IFN-γ)has been reported to play a key role in the pathogenesis of HLH, and antibody against IFN-γ(emapalumab)can be used to treat HLH.Here, the findings on the role of IFN-γ in pathogenesis and emapalumab in treatment of HLH are reviewed respectively.

Objective To investigate the feasibility of differentiation between prostate cancer and prostatitis by using metabolic ratios provided by 3D 1H Magnetic Resonance Spectroscopic Imaging (MRSI). Methods Metabolic changes were evaluated in 42 voxels with prostate cancer and 30 voxels with prostatitis in the peripheral zone using MRSI. The results were based on the pathologic findings by biopsy. The (choline + creatine)/Citrate (CC/C) ratio and the changes of choline and citrate levels were evaluated in each voxel with cancer or prostatitis, t test was used to determine the power of the CC/C ratio in differentiation between prostate cancer and prostatitis. Results The CC/C ratio for cancer voxels (1.28±0.41) was significantly different from the ratio in the voxles with prostatitis (1.03±0.40), t=6.45, P<0.05, due to greatly increased choline level in the cancer voxels. When CC/C ratio of 0.8 was taken as the criteria for the diagnois of prostate cancer, the sensitivity, specificity and accuracy were 65.5%, 71.4% and 66.7%, respectively. Positive predictive value(PPV)and negative predictive value(NPV) were 90.5% and 33.3%, respectively. The CC/C ratio was higher than 0.86 in 66.7% voxels with prostatitis (20 voxels of total 30 voxels), which mostly depended on the level of choline. When citrate level was used as an auxiliary index to evaluate prostatitis (Cit/norm, Cit≥0.75), the misdiagnosis rate of prostate cancer was reduced to 26.6%(8 voxels of total 30 voxels). Conclusions The metabolic ratio of CC/C can be used to differentiate prostate cancer from prostatitis. The misdiagnosis rate is reduced when citrate is not or slightly decreased relative to normal citrate level (Cit/norm, Cit≥0.75).

Abstract: Objective　To understand the characteristics of mutations associated with resistance among 72 multidrug-resistant tuberculosis (MDR-TB) strains using whole genome sequencing (WGS) and to evaluate the performance of WGS for predicting MDR-TB drug resistance. Methods　The clinical strains isolated from patients who visited the outpatient department of Tianjin Center for Tuberculosis Control from January to September in 2020 were collected. Identification tests using p-nitrobenzoic acid (PNB) medium were performed. Drug susceptibility tests (proportion method) on L-J medium were performed. After excluding duplicate strains, 72 MDR-TB strains were selected for WGS. Data were analyzed by using online databases and the phenotypic drug susceptibility test results were compared with resistance profiles predicted by WGS. Results　All of 72 MDR-TB strains belonged to linage 2, and there was no significant difference in rate of pre-extensive drug-resistant tuberculosis (pre-XDR-TB) between modern type and ancestral type (χ2=0.287, P=0.592). A total of 81 mutation types were found from resistance-related genes for 12 anti-tuberculosis drugs, and the common mutation types in different drug-resistant strains were: streptomycin (SM): rpsL Lys43Arg; isoniazid (INH): katG Ser315Thr; rifampicin (RIF): rpoB Ser450Leu; ethambutol (EMB): embB Met306Val; ofloxacin (OFX), levofloxacin (LFX), moxifloxacin (MFX): gyrA Asp94Gly; kanamycin (KAM), capreomycin (CAP), amikacin (AMK): rrs 1401a>g; para-aminosalicylic acid (PAS): folC Ile43Thr. Nine mutation types were found in 9 prothionamide (PTO)-resistant strains, one type for each strain. The sensitivity and specificity of WGS for predicting resistance to different drugs were SM: 98.15% and 88.89%, INH: 90.28% and -, RIF: 98.62% and -, EMB: 79.49% and75.76%, OFX: 97.30% and 85.71%, KAM: 85.71% and 98.46%, PAS: 27.27% and 95.08%, PTO: 81.82% and 60.66%, CAP: 60.00% and 98.51%, LFX: 97.22% and 83.33%, MFX: 97.30% and 85.71%, AMK:100.00% and 100.00%, respectively. Conclusion　WGS is a rapid and promising method which has high consistency with the phenotypic drug sensitivity test. Therefore, it has good application prospects in predicting drug resistance in MDR-TB.

Objective To investigate the clinical effect of super selective embolization combined with opera-tion for treatment of meningiomas.Methods 82 cases treated by operation and pathology in return for meningioma were collected in the study,including 44 cases of preoperative superselective embolization for aneurysms as the treat-ment group,and the remaining 38 cases without preoperative embolization of patients as the control group.The opera-tion time,bleeding amount in the operation and the rate of total tumor removal were recorded and compared between the two groups.Results The average amount of bleeding of treatment group was (330.36 ±95.41)mL.The average amount of bleeding of control group was (460.82 ±114.64)mL.The data of the two groups was statistically significant (t =5.624,P <0.01).,The treatment group bleeding amount was less than that of the control group;,the mean oper-ation time of treatment group was (5.36 ±2.62)h,,the average operation time of control group was (6.63 ±2.25)h.The data of the two groups was statistically significant (t =2.355,P =0.021 ),the operation time of the treatment group was less than that of the control group.The total resection rate was 70.4% in treatment group and 36.8% in the control group,there was statistically significant (P <0.05),and the total resection rate in the treatment group was higher than that in the control group.Conclusion Compared with single operation treatment of meningiomas superse-lective embolization combined with operation for treatment of meningiomas can shorten operation time,reduce intraoperative hemorrhage,improve the rate of total tumor removal.It can reduce the operation risk and improve the treatment effect.

Objective To analysis the risk factors in ventilator-associated pneumonia (VAP) in mechanically ventilated patients.Methods Seventy-eight adult inpatients on mechanical ventilation (MV) through oral endotracheal intubation were studied prospectively by observation between June,2007 and May,2010.Clinical associated factors including patients'predisposition related,medical personnel or device related and nutritional state related factors,etc.were recorded and analyzed.Results In 78 ventilated patients,the incidence of VAP was 23.1％,the fatality rate was 22.2％.Preventive antibiotic treatment (OR=6.038; 95％ CI:1.319-27.641; P =0.021),applying glucocorticoid (OR =5.385; 95％ CI:1.191-24.346; P =0.029) and prealbumin (PA) ≤ 69.7 mg/L (OR =0.975; 95％ CI:0.956-0.995 ; P =0.013) were risk factors in VAP.Conclusions The risk factors in VAP were PA ≤ 69.7mg/L,preventive antibiotic treatment and employment of glucocorticoid.

AIM To prepare D-α-tocopherol polyethylene glycol 1000 succinate (TPGS)-modified artesunate liposomes and to investigate the in vitro anti-tumor activity.METHODS The liposomes prepared by thin-film dispersion method were characterized by transmission electron microscopy and particle size analyzer,and the encapsulation efficiency was determined by ultrafiltration centrifugation.The liposomes' cytotoxicity to human hepatoma HepG2 cells was evaluated by MTT method.RESULTS The average particle size,PDI,Zeta potential,encapsulation efficiency,drug loading of the liposomes were 126.7 nm,0.182,-10.1 mV,78.8％ and 18.38％,respectively.The liposomes displayed a significant inhibition on HepG2 cells with the IC50 value of 0.034 μmol/mL.CONCLUSION Compared with non-TPGS-modified artesunate liposomes,the TPGS-modified artesunate liposomes prepared by this method afford smaller vesicle size,better stability and higher encapsulation efficiency with stronger in vitro anti-tumor activity.

Communicable Diseases ; genetics ; immunology ; Epstein-Barr Virus Infections ; genetics ; immunology ; Gene Frequency ; Genetic Association Studies ; Genetic Predisposition to Disease ; genetics ; Genotype ; HIV Infections ; genetics ; immunology ; Hepatitis B ; genetics ; immunology ; Hepatitis B virus ; genetics ; Humans ; Malaria ; genetics ; immunology ; Polymorphism, Single Nucleotide ; Toll-Like Receptor 9 ; genetics